Mouth to mouth resuscitator



Nov. 24, 1964 A. BLOOM 3,158,152

MOUTH TO MOUTH RESUSCITATOR Filed Sept. 16, 1960 gar m IN V EN TOR. H/mo/v BLOOM 3m af/ amalam,

ATTORNEYS United States Patent 3,155,152 MOUTH T0 MGUTH RESUSGTATQRAaron Bloom, Pasadena, Chili, assignor to Sierra Engineering Company,Sierra Madre, Callfi, a corporation of California Filed Sept. 16, 1969,Ser. No. 56,458 4 Claims. (Cl. l282) The invention relates toresuscitation for persons whose breathing has been temporarily impairedand consists of essentially a device the purpose of which is to providea means for month to mouth resuscitation without the necessity of directexchange of respiratory gases between the patient and the administratoror operator, the device being further one for controlling the tidalvolume displacement and thoracic pressure.

More particularly, the invention is directed to a device, one end ofwhich is insertable into the mouth of a patient and the other end ofwhich is applicable to the mouth of an operator, there being provided adivided chamber therebetween, separated by a flexible partition andsundry valving so arranged that the patient inhales fresh airindependently of the operator who also inhales only fresh air.

The problem of resuscitation or artificial respiration has longconfronted the medical profession and administrators of first aid. Mostcommonly artificial respiration is performed by manipulating the armsand chest cavity of a person needing resuscitation in order toalternately depress and expand the chest cavity and lungs in a sequenceendeavoring to simulate natural respiration. The

artificial respiration technique is the quickest and'most commonlyemployed because, when resuscitation is needed the need is urgent andimmediate and it must be practiced without delay if the patient on manyoccasions is to survive. Needless to say the practice of artificialrespiration of the kind described is eifective only in the hands ofpersons conversant with the technique and although badly neededoften-times fails to produce the necessary result because of lack ofskill on the part of persons immediately available.

On occasions where there is opportunity to employ mechanical respiratordevices such as the commonly known pulmotor have been employed. Thesedevices supplied by artificial pumps are capable of being regulated to amore realistic rhythm and have the advantage of an adequate amount ofpower by means of which to force fresh air into the lungs. The devicesheretofore available however have been somewhat complicated, expensiveto procure; and of such construction that unless handled by expertsdamage to the patient may be suffered.

On some occasions mouth to mouth resuscitation has been practiced by atechnique which requires the operator to place his own mouth over themouth of the patient, thereby to breathe air from the lungs of theoperator into the lungs of the patient. Although this direct method isphysically less tiring for the operator, it has the singulardisadvantage of making it necessary to breathe into the lungs of thepatient air having a heavy portion of carbon dioxide exhaled by theoperator and hence deprives the patient of an abundance of oxygen suchas would be present in the natural air. Also under extenuatingcircumstances where the patient may have been subjected to discomfortresulting in nausea it becomes extremely difficult for the operator toovercome a degree of physi cal repulsion to the extent necessary toadminister direct mouth to mouth resuscitation.

It is therefore among the objects of the invention to provide a new andimproved device for making possible use of mouth to mouth resuscitationin such fashion that natural air uncontaminated by the operator isforced directly into the lungs of the patient and thereafter permittedto be exhaled.

Another object of the invention is to provide a new and improved devicefor the performance of mouth to mouth resuscitation which is capable ofminimizing fatigue on the part of the operator while at the same timeaffording the patient the opportunity to breathe natural air and exhalenaturally.

Still another object of the invention is to provide ,a new and improvedapparatus for enabling the performance of mouth to mouth resuscitationwhich incorporates safety features in that the apparatus is built with amaximum capacity no greater than that which is a safe capacity for thelungs of the patient which capacity cannot be exceeded regardless of theinexperience of the operator.

Still another object'of the invention is to provide a new and improvedapparatus for the performance of mouth to mouth resuscitation whichmakes a direct physical contact between the patient and the operatorunnecessary.

Also included among the objects of the invention is to provide a new andimproved mouth to mouth resuscitation device which is relativelyinexpensive, which is compact and therefore easily portable and which,moreover, is positive and safe in its action, to thereby greatly improvethe administration of artificial respiration where needed.

With these and other objects in view, the invention consists of theconstruction, arrangement and combination of the various parts of thedevice whereby the objects contemplated are attained, as hereinafter setforth, pointed out inthe appended claims, and illustrated in theaccompanying drawings.

In the drawings:

FIGURE 1 is a longitudinal sectional view of the device of the inventionin its most complete form.

FIGURE 2 is a side elevational View of a more simplified form of thedevice with a portion broken away.

FIGURE 3 is a cross-sectional view taken on the line 33 of FIGURE 1.

FIGURE 4 is a schematic View of the device drawn to a smaller scale andillustrating the application of air ally by the reference characterIZco-nsists of a part 13 and a part 14 which are secured togetheradjacent flanges 15 and 16 respectively by means of some appropriatefastening means such as screws 17. Between the flanges there is secureda flexible diaphragm is which is reinforced over its central area by thepresence of a rigid cup 19 in a form such that the diaphragm is adaptedto flex adjacent its outer perimeter. The diaphragm being secured inseal relationship between the flanges l5 and 16 provides within thehousing two chambers namely a gas supply chamber 20 and a gas pressurechamber 21. Within the gas supply chamber 29 is a spring 22 one end ofwhich is received in the cup I? and the other end of which is adapted topress against an end wall 23 of the housing 12. Action of the spring 22serves normally to bias the diaphragm in a direction away from the endwall 23 and toward an end wall 24, thus to normally open the supplychamber 20 to its condition of maximum capacity.

A check valve device 28 is contained within a fitting 29 in the end wall23 and comprises a valve element 30 secured at the center by a valvestem 31 to a spider 32. Although various check valve devices areacceptable there is shown by way of example a check valve. devicewherein 3. the valve element 34 is of flexible resilient character suchthat it flexes away from the seat 33 when gas or air is sent through aninlet port or passage 34 into the supply chamber 20; The valveelementreseats upon the seat whenever pressure is exerted upon the gaswithin the supply chamber 29.

In the patient mouthpiece is a passage 35 for air which is incommunication past a combination inhalation-exhalation composite valvedevice 36. i

A bushing 37 defines an aperture 38 forming a passage in communicationwith the supply chamber 26'.

A nipple 39 to which the patient mouthpiece l d is secured includes aflange 4% having lateral openings 41 therein and which is made use of tosecure the nipple tothe bushing. A valve element 42' serves as a sealfor the rim of the bushing 37 and is compressed upon the bushing by theflange =59 which is secured thereto by appropriate means such as screws43.

The valve element 42 in the chosen embodiment has an annular flexiblebead 44 which under operating conditions permits a mid-portion 45 toshift from left to right as viewed in FIGURE 1. serve as a valve elementand to seat upon an annular valve seat 46 which is part of the nipple39. In thernid-portion 45 are openings 47 and mounted upon themid-portion is a flexible check valve element 43. A stem idol the checkvalve element securely fastens the check valve element to themid-portion at its center. The check valve element 43 includes aflexible head 56 in the chosen embodiment which permits the outerperimeter of the check valve cle merit to lift from an annular valveseat 51.

On the opposite side of the housing 12, the operator mouthpiece 11 isconnected thereto by means or" a tube 52 which forms a passage 53. Abushing 54 mounted centrally in the end wall 24 providing a passage 55therethrough in combination with the pressure chamber 21, the passage 53and the area within the operator mouthpiece 11 may be aptly described asa composite pressure cavity.

At the left end of the tube 52 as viewed in FIGURE 1 is a flange 56 uponwhich is seated the outer annular portion of a valve element 57. Thebushing 54 is providedwith a flange 58 having openings 59' therethroughwhich establish a pressure vent port. is also provided an annular valveseat 60 upon which a mid-portion 61 of the valve element 57 is adaptedto seat. The valve element includes a flexible head 62 in the chosenembodiment which permits the mid-portion to move from left to right awayfrom the seat 69 and to return thereto at appropriate phases of thecycle.

Mounted upon the mid-portion 61 is a flexible valve element 63 whichbeing likewise provided with a flexible beaded portion or bead 64 isenabled to have the rim thereof move from right to left away from anappropriate annular seat 65 at appropriate phases of the cycle. A valvestem 66 is employed to anchor the valve element 63 to the mid-portion 61of the valve element 57.

On one side of the tube 52 is a fitting 67. A valve element 68 offlexible character similar to the valve element 30 is secured by meansof the stem 69 to a spider 70' in such fashion that when air or gaspasses into the inlet port 67 through openings 71 the valve element 68is lifted from a seat 72 thereby to admit air or gas into the passage53.

The operator mouthpiece is of such character that an extension 73thereon may have a snug slip fit over the tube 52 in such manner thatwhen needed the mouthpiece can be removed for replacement by anothermouthpiece which may be a newly sanitized mouthpiece or one belonging toa different operator.

Although the device in the form described is well suited to use inatmosphere occasions may arise where the at- The mid-portion is adaptedto On the bushing 54 there mosphere is contaminated with smoke, toxicfumes or irritants to the extent that pure oxygen or purified air may bepreferable. Under such circumstances a tank 75 of oxygen may be attachedby means of a hose 76 to the 4 fitting 29 at the patient side of thehousing. Similarly a tank 77 of oxygen or other gas may be attached by ahose 78 to the fitting 67 thereby to substitute a selected gas for thenormally surrounding atmosphere.

In use the patient mouthpiece is inserted between the teeth of the mouthof the patient. The operator then up plies his mouth to the operatormouthpiece 11 and when passinto the pressure chamber 21. The operatorcan continue to exhale through this phase of the cycle wherein thediaphragm 18 is moved from right to left as viewed in FIGURE 1 until thecup rests against the end wall 23. During this phase air which is withinthe supply chamber 20 will pass through the aperture 38, openings d7 inthe valve element 42 and lift the valve element 48' from its positionupon the seat 51 thereby gaining access to the passage 35 and the oralcavity of the patient.

After the operator ceases to exert exhaling pressure and proceeds toinhale, air from the surrounding atmosphere will pass through the inletport 67' to supply the operator with fresh air. At the same time therespiratory gases which filled the pressure chamber 21 will be pushedagainst the valve element 63 thereby closing that valve element andcontinued pressure willmove the valve element 57 from left to right awayfrom the seat 6t? thus permitting the respiratory gases to passoutwardlythrough the vent open-- ings 59. Expulsion of the respiratory gases inthe manner described is assisted by action of the spring 22 which tendsto move the diaphragm from left to right as viewed in FIGURE 1.

At the same time air from the surrounding atmosphere is drawn throughthe air supply passage 34 unseating the valve element 38 from its seatand thus fills the supply chamber 29 with fresh air to the maximumcapacity of the chamber. During the filling phase the valve element 48is seated upon its seat toprevent respiratory gasesfrom the patientfinding their way into the supply chamber 20'; At the same time thepatient is exhaling and the respiratory gases pass through the passage59 unseating the valve element 42 thereby finding their way past thevalve seat 46 through the openings 41 comprising the exhaust port intothe surrounding atmosphere. It will be appreciated that where tanks 75and 77 are connected to the appropriate fittings Z9 and 66 the fresh airmay constitute pure oxygen or other gas supplied to either the patient,operator or both, but that upon exhaling respiratory gases from thepatient, operator or both are expelled outwardly to thesuroundingatmosphere.

In the embodiment of the invention shown in FIGURE 2 valving has beenomitted from the operator side of the device where a straight tube 39 isemployed to connect the operator mouthpiece 11 with a bushing 81 on thepart 14 of the housing 12. Valving is also omitted from the bushing 81.The valves previously described, however, are employed on the patientside. In this more simplified form of the invention the same safeguardsare present in that the housing provides a supply chamber 20 the maximumcapacity of which is adapted to the type of pa tient to whom theresuscitation is to be administered. In

this instance the operator inhales through the side of his For use withinfants the supply passage customarily is. made with a capacity of aboutcubic centimeters which is a volume very slightly in excess of the needof an infant. Where the device is for use in resuscitating adultpatients the supply chamber is made with a capacity of about 800 cubiccentimeters. A device of the last described capacity is also suitablefor children even though the lung capacity of children may be as low as300 cubic centimeters for the reason that with children over pressuringis not harmful, at least to an extent defined by the maximum capacityherein made reference to.

From the foregoing description it will be clear that regardless of howthe device might be operated no more air can be pressured into the lungsof the patient than can be contained within the supply chamber 20 foreach cycle. For best results it is advisable to apply pressure at arecommended rhythm of from 6 operations per minute to 10 or 12operations per minute. The latter rate is an approximate rate when understimulated conditions. Since the rate of application of air to the lungsof the patient is substantially the same as the average rate ofbreathing of the operator the resuscitation procedure can continue forlong periods of time without fatigue to the operator and moreoverwithout the prospect of tiring the operator by reason of making theoperators intake of fresh air restricted in any fashion. Also thereremains a sufiicient distance between the operator and the patient andabsence of physical contact so that there need be no psychologicalimpediment to an efiective and eflicient administration of theprocedure. Where resuscitation may need to continue for a time longerthan one operator can support a second or additional operators eachsupplied with an individual mouthpiece can be substituted from time totime without it being necessary to remove the patients mouthpiece fromthe patients mouth.

in the event that employment of normal air might become insufiicientduring any interval during the administration oxygen can be connected tothe supply for the patient at any time without interruption of theadministrating technique.

Although I have herein shown and described my invention in what I haveconceived to be the most practical and preferred embodiment, it isrecognized that departures may be made therefrom within the scope of myinvention, which is not to be limited to the details disclosed hereinbut is to be accorded the full scope of the claims so as to embrace anyand all equivalent structures and devices.

Having thus described my invention, what I claim as new and desire tosecure by Letters Patent is:

1. A mouth to mouth resuscitator comprising a supply chamber member anda pressure chamber member attached to the supply chamber member, animperforate movable partition separating the interiors of said membersfrom communication with each other, an operator mouthpiece incommunication with the interior of the pressure chamber member, apatient mouthpiece in communication with the interior of said supplychamber member, the interior of said supply chamber member and a spaceadjacent the operator mouthpiece each having a separate fresh gas supplyport in communication between the respective interior and the exterior,each said supply port having an inflow check valve therein, a passagewaybetween the interior of each of the chamber members and the respectivemouthpiece, the passageway adjacent the patient mouthpiece having aninflow check valve therein and the other passageway having an outflowcheck valve therein, and a valved vent port from the pressure chambermember and from the passageway adjacent the patient mouthpiece to theexterior.

2. A mouth to mouth resuscitator comprising a mouth piece insertable inthe oral cavity of a patient, and having a passage therethrough, meansforming a gas supply chamber of variable size in communication with saidpassage, means forming a gas pressure chamber, and an operatormouthpiece in communication with said pressure chamber, said supplychamber having a maximum fixed capacity not exceeding a normal expandedlung capacity of the patient, a movable partition separating saidchambers, and means operably associated with said partition biased in adirection moving said partition to a position enlarging said supplychamber to maximum capacity, a supply port in communication with saidsupply chamber having a check valve therein open to inflow of gas, adouble acting check valve device between the supply chamber and saidpassage, said check valve device having an element movable to openposition under flow of gas from said chamber to said passage and toclosed position under flow of gas from said passage, an exhaust portmeans between said passage and atmosphere, and another element of saidcheck valve device in said passage and movable to a position closingsaid exhaust port under flow of gas from said chamber to said passageand to a position opening said exhaust port under flow of gas from saidpassage,'said operator mouthpiece including a pressure passagecommunicating with said pressure chamber, a pressure vent port betweensaid pressure chamber and atmosphere, a double acting valve devicehaving an element movable to open position under flow of gas from saidoperator mouthpiece to said pressure chamber and to closed positionuponrelease of said last flow, said last valve device having anotherelement movable to a position opening said vent port under flow of gasfrom said pressure chamber, an inlet port between atmosphere and saidoperator mouthpiece, and a check valve in said inlet port movable toopen position under flow of gas into said operator mouthpiece.

3. A mouth to mouth resuscitator comprising a mouth-.

piece insertable in the oral cavity of a patient, and having a passagetherethrough, a housing having a flexible partition therein dividingsaid housing into a gas supply chamber of variable size and a gaspressure chamber of variable size, said supply chamber having a maximumfixed capacity not exceeding a normal expanded lung capacity of thepatient, said supply chamber being in communication with said passage,and resilient means operably associated with said partition biased in adirection moving said partition to a position enlarging said supplychamber to maximum capacity, a supply port in communication with saidsupply chamber having a check valve therein open to inflow of gas, acheck valve element in said passage movable to open position under flowof gas from said chamber to said passage and to closed position underfiow of gas from said passage, an exhaust port means between saidpassage and atmosphere, a check valve element between said passage andsaid exhaust port and movable to a position closing said exhaust portunder flow of gas from said chamber to said passage and to a positionopening said exhaust port under flow of gas from said passage, anoperator mouthpiece, a tube connecting said operator mouthpiece and saidhousing, said tube comprising a pressure passage communicating betweensaid last mouthpiece and said pressure chamber and forming with saidmouthpiece and said pressure chamber a composite pressure cavity, apressure vent port between said cavity and atmosphere, a check valveelement in said tube movable to open position under flow of gas fromsaid operator mouthpiece to said pressure chamber and to closed positionupon release of'said last flow, a check valve element between saidcavity and said vent port movable to a position opening said vent portunder flow of gas from said pressure chamber, an inlet port betweenatmosphere and said cavity on the side of said last check valve nearestthe operator mouthpiece and a check valve in said inlet port movable toopen position under flow of gas into said cavity.

4. A mouth to mouth resuscitator comprising a mouthpiece insertable inthe oral cavity of a patient and having a passage therethrough, ahousing having a flexible partition therein dividing said housing into agas supply chamber and a gas pressure chamber both of variable size,said supply chamber having a maximum capacity not exceeding a normalexpanded lung capacity of the patient, said 7 supply chamber being incommunication with said passage, and resilient means operably associatedwith said partition biased in a direction moving said partition to aposition enlarging said supply chamber to maximum capacity, a supplyport in communication with said supply chamber having a single actingcheck valve therein open to inflow of gas, a double acting check valvedevice between the supply chamber and said passage having two valveelements, one of said valve elements being movable to open positionunder flow of gas from said chamber to said passage and to closedposition under flow of gas from said passage, an exhaust port meansbetween said passage and atmosphere, and another of said valve elementsbeing in said passage and movable to a position closing said exhaustport under flow of gas from said chamber to said passage and to aposition opening said exhaust port under flow of gas from said passage,an operator mouthpiece, a tube connecting said operator mouthpiece andsaid housing, said tube comprising a pressure passage communicatingbetween said mouthpiece and said pressure chamber and forming with saidlast mouthpiece and said pressure chamber a composite pressure cavity, apressure vent port between said cavity and atmosphere, a double actingvalve device having two valve elements, one of said last identifiedvalve elements being movable to open position under flow of gas fromsaid op erator mouthpiece to said pressure chamber and to closedposition upon release of said last flow, the other of said lastidentified valve elements being movable to a position opening said ventport under flow of gas from said pressure chamber, an inlet port betweenatmosphere and said cavity on the side of said last double acting checkvalve nearest the operator mouthpiece, and a check valve in said inletport movable to open position under flow of gas into said cavity, saidsingle acting check valves having means operatively associated therewithfor attachment to gas supplies of selected character.

References (Iited in the file of this patent UNITED STATES PATENTS2,428,451 Emerson Oct. 7, 1947 2,766,753 Koch Oct. 16, 1956 2,887,104Sovinsky May 19, 1959 FOREIGN PATENTS 1,204,285 France Aug. 3, 19591,207,372 France Aug. 31, 1959

1. A MOUTH TO MOUTH RESUSCITATOR COMPRISING A SUPPLY CHAMBER MEMBER ANDA PRESSURE CHAMBER MEMBER ATTACHED TO THE SUPPLY CHAMBER MEMBER, ANIMPERFORATE MOVABLE PARTITION SEPARATING THE INTERIORS OF SAID MEMBERSFROM COMMUNICATION WITH EACH OTHER, AN OPERATOR MOUTHPIECE INCOMMUNICATION WITH THE INTERIOR OF THE PRESSURE CHAMBER MEMBER, APATIENT MOUTHPIECE IN COMMUNICATION WITH THE INTERIOR OF SAID SUPPLYCHAMBER MEMBER, THE INTERIOR OF SAID SUPPLY CHAMBER MEMBER AND A SPACEADJACENT THE OPERATOR MOUTHPIECE EACH HAVING A SEPARATE FRESH GAS SUPPLYPORT IN COMMUNICATION BETWEEN THE RESPECTIVE INTERIOR AND THE EXTERIOR,EACH SAID SUPPLY PORT HAVING AN INFLOW CHECK VALVE THEREIN, A PASSAGEWAYBETWEEN THE INTERIOR OF EACH OF THE CHAMBER MEMBERS AND THE RESPECTIVEMOUTHPIECE, THE PASSAGEWAY ADJACENT THE PATIENT MOUTHPIECE HAVING ANINFLOW CHECK VALVE THEREIN AND THE OTHER PASSAGEWAY HAVING AN OUTFLOWCHECK VALVE THEREIN, AND A VALVED VENT PORT FROM THE PRESSURE CHAMBERMEMBER AND FROM THE PASSAGEWAY ADJACENT THE PATIENT MOUTHPIECE TO THEEXTERIOR.